I NEED YOU TO RESPONSE TO TWO DIFFERENT TOPICS OF DISCUSSION QUESTIONS. PLEASE RESPOND TO THE EACH DISCUSSION. (EX. AGREEING TO THE DISCUSSION AND WHY?) i HAVE ENCLOSED THE READING MATERIAL FOR THIS TOPIC; READING CHAPTERS 5,6, & 7. OUTSIDE SOURCE IS OKAY. DISCUSSION # 1. Dorothy Johnson’s theory about continuity of systems is spot on. Comparing our body to a well-made machine, such as a car. The car has multiple systems just as our body, such as coolant, electrical, lubrication, computer. Without each one of these systems working in continuity you will end up stranded because it fails. Such as a coolant leak can end with catastrophic engine failure, or a faulty electrical system leads to non-starting conditions. A good example to compare with the clinical setting is Congestive Heart Failure. When the heart can no longer keep up with needs of the circulatory system it becomes backed up or overloaded with fluids. Generally, the first sign the victim notices is shortness of breath with ambulation. Many patients think they are having lung problems due to heavy breathing and do not consider that its their heart and poor circulation giving them this grief. A survey conducted in the united kingdom concluded “CHF is associated with lower cognitive functioning in a population of patients with stable heart failure in primary care settings.” (Lavery 2007) The fact that CHF leads to poor circulation and oxygenation to the brain means that the brain is now working on less than adequate perfusion. Cognitive functioning decreases, this means the patient is now at a disadvantage, learning how to reverse or manage their CHF symptoms properly is less likely. Due to fluid overloading, the legs start swelling and cause damage to tissue. Ambulation is decreased due to pain, shortness of breath along with weight gain. The old saying “if you don’t use it, you lose it” (old people) is a phrase that comes true. Less ambulation further decreases circulation and weakens the body further, even increasing the risk of blood clots or bed sores. Cognitively impaired patients are unable to manage CHF symptoms and quickly become entrapped in the revolving door of hospital admissions for CHF exacerbation followed by a physical rehab to return to baseline abilities. Another study, (Rehn 2012), compares muscle fatigue with CHF and COPDpts to normal deconditioning. This study seems to conclude that there is not any difference and perhaps deconditioning due to lack of use is the reason for most pts declining physical abilities who have CHF or COPD. People tend to sit or rest when they don’t feel well, shortness of breath can be scary and is avoided at all costs to include exercise, when they break the cycle of walking and being active it affects their entire system. Decreased physical abilities and feeling physically unwell can also lead to mental deconditioning such depression or decreased cognitive abilities. Everything is connected. We must think about the full picture when caring for people. DISCUSSION # 2. The utilization and application of nursing theories in addressing a number of clinical issues have proven to be very useful for nurses trying to make a change in how the healthcare system works while ensuring quality patient care. During her career, Dorothy Johnson addressed some of these issues and used Nightingale’s and other important theorists’ ideas to develop her behavioral system model (Parker & Smith, 2015). This system has been helpful in improving patient care and communication between nurses by focusing on the person and recognizing that all humans have biological and behavioral needs that must be met in order to maintain balance. According to the Johnson behavioral system model (JBSM), each individual has a patterned, purposeful and repetitive way of acting and each person’s behavioral system must be efficient and effective to prevent illness. The behavioral system is composed of seven subsystems: affiliative, dependency, ingestive, eliminative, sexual, aggressive, and achievement (Parker & Smith, 2015). Each subsystem has a goal and a function and are interrelated, so they influence each other and depend on each other to create a behavioral system balance. When any of the subsystems do not fully develop or are lacking in any area, the system falls out of balance causing people to become or remain ill. The subsystems are also affected by external factors such as the environment, as well as socio-cultural, physical and economic factors. The environment is the main external factor affecting an individual’s behavior, and the nurse is responsible for manipulating the environmental elements to achieve health or stability for the patient (Parker & Smith, 2015). Nursing homes have elderly patients who are in great need for their behavioral system balance to be restored. They are dependent on the nurses for care as they grow older and lose the ability to care for themselves. They may become aggressive if they get angry or feel impotent about their care or because they are unfamiliar with the environment they are living in. They can also feel sad that they are not able to spend time with the people they became affiliated with such as family and friends. This may cause patients to refuse eating and can even affect their ability to eliminate wastes from the body. Nurses need to be patient with these patients and build rapport, so they can earn their trust and find ways to help them achieve a sense of wholeness. They also need to be able to identify which of the seven subsystems is not functioning correctly, so they can find ways to restore balance and assist the patient in changing the unconscious or conscious behavior. The nurse should also recognize problems in the environment and stimulate the patient to share their feelings about what is bothering them in order to find a resolution and improve behavior.
Solution preview for the order on discussion responses to Johnson’s model theory